by Iskra

Created on: August 30, 2010   Last Updated: August 31, 2010

 Mirtazapine is the generic name for a Tetracyclic anti-depressant commonly bearing the brandname Remeron in the USA and Zispin in the UK.  Physicians primarily prescribe Mirtazapine in the treatment of long term depression especially where anxiety is a secondary feature. It has a secondary use as a hypnotic aid in those with acute insomnia.  Mirtazapine comes in strengths of 15, 30 and 45 milligrammes in tablet or in a lingually soluable tab.  Mirtazapine was approved by the FDA in 1996 as a first line treatment for depressive disorders.  Mirtazapine has proved a popular medicine with patients due to it's nocturnal sedation qualities.

Mirtazapine is taken generally at bedtime or on the specific directions of a health care professional.  Like most anti-depressants the full benefits of Mirtazapine may only become apparent after several weeks and patients usually start their treatment at the lowest dose. 

Common reported side effects of Mirtazapine use include: weight gain, drowsiness, dry mouth, increased appetite, increased cholesterol, constipation, confusion, manic episodes and less commonly changes in blood pressure and decreased blood cells. It is advised by the manufacturers, the National Institute for Clinical Excellence (NICE) and the online Pharmaceutical reference service Medicinenet.com that abrupt discontinuation in the use of Mirtazapine can cause mild to serious withdrawal symptoms including: dysphoria, mood swings, headache and fever.  Unpleasant symptoms have been reported when only a few doses of Mirtazapine have been missed.

Studies have revealed that some medicines used in the treatment of depressive illness can cause suicidal thoughts in children and young adults.  In adults using anti-depressant medication there have also been reports of an increase in suicidal tendencies underlying the need for a patient's treatment to be regularly reviewed by a health care professional.

Unlike the popular and much more widely known Selective Serotonin Re-uptake Inhibitors (SSRI) anti-depressants such as Prozac/Fluoxitine and Effexor, Mirtazapine improves depression by raising the level of nor-epinephrine and serotonin neurotransmitters in the nerves of the brain. It also acts as an anti-Histamine. Patients are advised not to take Mirtazapine with: Benzodiazepines such as Diazepam or Xanax due to very probable over sedation. Similarly, use with Opioid analgesics such as Oxycodone should be avoided due to possible over sedation. Mirtazapine has possible fatal interactions with Monamine Oxidise (MAO) inhibitor drugs.  Patient information leaflets distributed with Mirtazapine warn of the potential for Serotonin poisoning if used with other drugs used in the treatment of depressive illness such as the SSRI Prozac or the mood stabiliser Lithium.

Like all precription medicines Mirtazapine must not be used unless under the guidance of a qualified healthcare professional.

Learn more about this author, Iskra.
Click here to send this author comments or questions.